The Value Of Energy Spectral CT In Diagnosis Of Hepatocellular Carcinoma And Evaluating Curative Effect Of TACE

Objective: To study the diagnosis of hepatocellular carcinoma(HCC)and the curative effect of TACE on HCC by Spectral CT.Materials And Methods: 63 patients with HCC and 33 patients with cirrhosis who underwent three-phase Spectral CT were retrospectively analysed.Among them,28 cases underwent Spectral CT without any treatment previously.And 35 cases underwent procedures of TACE one or more times.Iodine concentration of liver parenchyma,tumor,portal vein and aorta were measured from material decomposition map of Spectral CT by using water and iodine as basic material pairs.Normalized Iodine concentration(NIC)and Iodine concentration ratio(ICratio)were calculated.Iodine concentration of cirrhotic liver parenchyma with different Child-Pugh grades were compared.And parameters of HCC in different groups were compared.Results: Values of AP NIC and ICratio in Child-Pugh C group were higher than those in Child-Pugh A and Child-Pugh B groups.And monochromatic imagings could significantly promote image quality and the detection of HCC.The values of AP NIC with satisfied accumulated of iodized oil were obviously higher than those in lesions with unsatisfied accumulation.No differences of ICratios and VP NIC were found between groups.Moreover,in same lesions,parts of HCC with preferable accumulation of iodized oil have higher ANIC values than parts without accumulation.Values of AP NIC and ICratios in tumors without treatment were significantly higher than those in residual tumors after TACE.Morever,Values of AP NIC and ICratios in residual tumors with treatment of TACE over 4 times were lower than those which received TACE1-4 times.Conclusions: Monochromatic imagings from Spectral CT could significantly promote image quality and the detection of HCC.Iodine concentration obtained by Spectral CT could be an useful method to predict lipiodol accumulation of HCC after TACE and evaluate curative effect of TACE.